Rural Appalachian populations have greater rates of obesity and chronic diseases attributed to lesser consumption of fruits and vegetables (F/V) and physical inactivity. Barriers to F/V consumption and physical activity include poor access and affordability. To help overcome these barriers, a community-initiated walking and farmers market F/V voucher program was implemented. Participants were encouraged to walk (1.2 miles roundtrip) to the local farmers market to redeem a $10 voucher which could only be spent on F/V. The 16-week program (June – Sept) included 121 participants. Data was analyzed by creating two groups, low-engagers and high-engagers that differed significantly in the number of times walked to the market and redeemed vouchers, p ≤ 0.0001. Among all participants’ significant decreases were seen in total cholesterol, LDL, ratio of total cholesterol/HDL cholesterol, 10-year risk of heart disease or stroke score, and hemoglobin A1c (p ≤ 0.05). Significant increases were seen in HDL, quantity and variety of F/V consumption among all participants and the high-engagers group. There were improvements in knowledge pertaining to participants’ awareness of the term “phytonutrient” with correctly identifying plant-based foods as the source (p=0.01). Results demonstrate that a community-based walking and farmers market F/V voucher program can improve health in a Rural Appalachian population.

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